WINCHESTER COLLEGE CONTROL AND ADMINISTRATION OF MEDICINES. Implementation Date 6 February Review Date 28 March 2017

Transcription

1 WINCHESTER COLLEGE CONTROL AND ADMINISTRATION OF MEDICINES Implementation Date 6 February 2011 Review Date 28 March 2017 Next Review Date 28 March 2018 Author 2M Approved SMC 26 April 2017 This protocol describes the control and administration of medicines at Winchester College Medical Centre (WCMC) and in the boarding houses (for the purposes of this document, the latter phrase includes College). Control of Medicines o All medicines should be kept in their original containers, complete with information sheet, in a locked cupboard within WCMC or the boarding houses, under the care of the School s or s respectively. o s, and Relief s (in the s absence), can administer medicines to Winchester College boys only. s can administer medicines to Winchester College boys, members of staff and visitors to Winchester College. Staff accompanying school trips can administer medicines named on the Winchester College Homely remedies protocol for school trip first aid kits once it has been signed by the relevant personnel. o Specimen signatures should be kept of every person who is authorised to administer medicines. All records should be properly completed and legible, and they should provide an audit trail for all medicines. o Over The Counter (OTC) medicines should be administered according to the Homely Remedy protocol below. These medicines will be purchased by WCMC. o Prescribed medicines must be given only to the boy that they are prescribed for. o Medicines (other than complementary, alternative, homeopathic medicines or those already prescribed by the school doctor) brought from home should be accompanied by a letter from a parent or doctor, addressed to. Complementary medicines, including homeopathic and alternative medicines, can only be given if the appropriate consent form (see Appendix 1) has been completed by a parent / guardian. o Controlled drugs should always be checked by two people when possible. It is accepted that when there is only one nurse on duty at WCMC, or one matron in the boarding houses, this would be difficult to achieve and it would then be acceptable to ask the recipient of the controlled drug to be the second checker. Controlled drugs should be stored separately and separate records kept of their administration. Only those individuals with authorised access to the controlled drug cupboard should hold a key.

2 For disposal, all controlled drugs should be returned to Pharmacy and the record completed accordingly. o When a prescription of controlled drugs is to be collected from WCMC the matron will take the green recording book along to collect the medication. At WCMC the matron and nurse will then start the tally in the green book. The signing-off of the medication as received will therefore include the signing-off of the numbers of tablets on the tally. This will necessarily require the medication packages to be opened at WCMC before they are then transferred to house storage. o Boys who are 16 or over and considered eligible to self-medicate, need to complete a risk assessment form (see Appendix 2) prior to self-medicating. Only dermatology treatments (with the exception of Roaccutane), routine antibiotics, anti-histamine therapy and asthma preventer inhalers can be self-administered. A maximum of one week s supply can be given at any one time. NB. Reliever inhalers, epipens and other emergency medicines should be carried at all times, by all relevant boys. Boys carrying any of these emergency medicines still require a risk assessment to be completed. Once the risk assessment has been approved by, the boy should then seek final approval to self-medicate from a WCMC nurse. o Only prescribed medicines and OTC medicines included in the Homely Remedy policy can be given without the prior consent of the school doctor or parent, except in extreme emergency when certain drugs listed under Article 7 of the Prescription Only Medicines (Human use) Order 1997, such as Adrenaline and Hydrocortisone, can be given by anyone for the purpose of saving life. o All medicines coming into, or going home from, school should be recorded for each pupil. A record should be kept of any medicine that is returned to Pharmacy. The record should include date of returning the medicine, the name of the pupil for whom it was prescribed, the name and dose of the medicine, the amount of medicine being returned, the signature of the returning staff member and confirmation of receipt of medicine obtained from pharmacy. o A tally must be kept of the total number of Paracetamol tablets kept in WCMC and in each boarding house. o Drug fridges must be kept locked when in use, and a daily recording kept of their temperature. If the temperature is outside the normal limits ie. 2-8 c it should be reported to WCMC promptly. o Vaccines should be given in accordance with WCMC vaccination protocol. o Records should be retained for a minimum of 15 years. Administration of Medicines o Before giving a medicine to a boy, member of staff or visitor, the person administering it must ascertain any known allergies and relevant past medical history, as well as any medicines presently being taken and the time they were last taken. Contraindications and side-effects should also be checked. o A boy / member of staff / visitor should be asked his name for proof of identity. If there is any doubt as to a boy s identity, he should be asked to confirm his date of birth. o All medicine should be taken under the supervision of the person issuing it.

3 o Any medicines administered to a boy / member of staff / visitor must be recorded in the appropriate book. The date, time, name of recipient, name of the medicine, dose, reason for giving (or not giving) the medicine and a signature must be included. Initials can be used for signatures in boarding houses, but no other abbreviations should be used. When matrons administer any medicine they should immediately the WCMC with the above information to ensure that staff at WCMC are aware. Similarly when nurses at WCMC administer any medicine they immediately the pupil s matron with a white slip giving all details. o Any drug error or suspected adverse drug reaction should be reported to the School Doctor as soon as possible. o This policy is reviewed annually. Confiscation of Medicines in Boarding Houses For the safety of all boys the School does not allow any medicines, homeopathic, herbal or oriental, in boarding houses without the prior permission of the Housemaster, and WCMC. The following must be observed: Parents must complete a medical consent form on the boy s admission to the School. Boys must not under any circumstances share, swap or trade their medication with each other. All medication must be in its original packaging, labelled with the boy s name, dosage and frequency in English. s are responsible for keeping medication safe and secure in the boarding houses Medication found unauthorised in a boy s possession will be confiscated. In such cases the Housemaster will document the incident and send a copy to WCMC. Confiscated medication will be sent to WCMC for disposal in accordance with protocol.

4 WINCHESTER COLLEGE HOMELY REMEDIES PROTOCOL - FOR BOARDING HOUSES AND WCMC Medicine Indication Dose Max. dose in 24 hour period Arnica cream Bruising Smooth sparingly onto affected area Bite & Sting Relief cream Cetirizine Hydrochloride 10mg tablets (Cetirizine, Zirtek, Benadryl) Chlorphenamine 4mg tablets Mild pain, itching and swelling caused by insect stings, bites & nettles Allergy such as hayfever. Mild allergic reaction Mild allergic reaction Smooth sparingly onto affected area 10 mg daily 10mg (one tablet) 4mg every 4-6 hours (Piriton) Deep Heat rub Stiff muscles Apply to affected area Contra-indications & special precautions Skin must be intact 2-3 times Skin must be intact 24mg (six tablets) Allergy to ingredients or antihistamines Eczema Pregnancy or breast-feeding Drowsiness rare, but can occur. Prostatic hypertrophy, urinary retention, glaucoma, pyloro-duodenal obstruction, liver disease. May cause drowsiness & blurred vision can seriously affect ability to drive or operate machinery Skin must be intact Can be given by: Max. duration of treatment before contacting WCMC

5 with gentle massage Medicine Indication Dose Max. dose in 24 hour period E45 cream Ibuleve gel Ibuprofen 200mg tablets (Nurofen) Dry skin Mild eczema Muscle sprains Backache Mild to moderate pain musculoskeletal, dental, earache Smooth sparingly onto affected area Apply sparingly. Gently massage into skin 1-2 tablets 4 hourly 3 times daily NB. dosage if taking orally at same time 1200mg (six tablets) Avoid contact with eyes & mucous membranes Contra-indications & special precautions Asthma Peptic ulcer Avoid contact with eyes, mucous membranes, inflamed or broken skin Discontinue if rash develops Wash hands after use Asthma May cause gastrointestinal irritation should be taken after food Can be given by: Max. duration of treatment before contacting WCMC 7 days Olbas Oil Congestion due to common cold 2-3 drops on tissue or in hot water as an inhalation Avoid contact with eyes & mucous membranes Olive Oil Paracetamol 500mg To soften ear wax only if WCMC request Mild to moderate pain Relief of viral illness symptoms 2 ml daily, if requested. 500mg every 4-6hours (under16years) 2g(four tablets) under 16 years Ensure patient is not taking any other Paracetamol-containing product Liver or kidney impairment N/A

6 Paracetamol 500mg (soluble) Common cold 1g every 4-6 hours (16-18 years) 4g (eight tablets) years Alcohol dependence As above As above As above As above Medicine Indication Dose Max. dose in 24 hour period Petroleum jelly Dry lips Apply sparingly As necessary Rennie tablets Indigestion 2 tablets to be Sixteen sucked or tablets chewed Rinstead pastilles Mouth ulcers 1 pastille Twelve Dental irritation every 2 hrs pastilles 0.9% Saline pods Superficial Topically wounds Eye bath Simple Linctus Mild, nonspecific 5ml 3-4 times cough daily Throat lozenges Sore throat As per packet As per packet Contra-indications & special precautions Pregnancy Allergy to any of the ingredients Can be given by: 20ml Encourage fluids Encourage fluids Max. duration of treatment before contacting WCMC 2-3 hours. If symptoms severe, contact WCMC 7 days 1 day 7 days 3-4 days

7 WINCHESTER COLLEGE PROTOCOL - FOR WCMC ONLY Medicine Indication Dose Max. dose in 24 hour period Adrenaline Benzyl Penicillin Chloramphenicol eye drops Dioralyte Fluorescein eyedrops Hydrocortisone 100mg IM amps Suspected anaphylactic reaction Suspected meningococcal meningitis Acute infective conjunctivitis Diarrhoea & vomiting for 48 hours if dehydrated Suspected anaphylactic reaction Epipen 0.3mg or Adrenaline 500mcg IM After each loose motion Contra-indications & special precautions Cardiac condition More than 48 hour history Recent overseas travel Diabetes Kidney and liver impairment Can be given by: Anyone in emergency situation use use use Use Maximum duration of treatment

8 Hyoscine hydrobromide 300mcg (Kwells, Joyrides) Loperamide 2mg tablets Prevention of Motion sickness Treatment of diarrhoea for travel or work requirements 300mcg thirty mins. before journey, then 6 hrly if req. 2 tablets initially, then 1 after every loose stool 900 mcg Can cause drowsiness Glaucoma Cardiovascular disease Kidney impairment 16mg (eight tablets) Keep hydrated Known liver disease 5 days Sodium Bicarbonate 5% eardrops Deafness caused by excessive ear wax 3 drops to affected ear twice daily Medicine Indication Dose Max. dose in 24 hour period Oxygen Prednisolone 5mg tablets Salbutamol 100mcg inhaler Salbutamol 5mg nebules Vaccinations: Hepatitis A Hepatitis B Hepatyrix Influenza Meningitis ACWY Emergency treatment Asthma Asthma Bronchospasm Severe asthma attack As per the Department of Health Immunisation against infectious 2 puffs then 1 per minute via volumatic 5mg via nebuliser Recurrent otitis media or pain/itching in ears Previous ear surgery Perforated ear drum or persistent deafness No wax visible on initial examination Contra-indications & special precautions Cardiovascular disease Diabetes Hyperthyroidism Cardiac arrhythmias As above Can be given by: Verbal order from GP use use use Prescribed by GP 3 days Maximum duration of treatment

9 Meningitis C MMR Pneumococcal Revaxis Typhoid diseases website WINCHESTER COLLEGE HOMELY REMEDIES PROTOCOL FOR SCHOOL TRIP FIRST AID KITS Winchester College staff may give the following medicines in accordance with the protocol below. All medicines administered must be recorded in the first aid kit book. Medicine Indication Dose Max. dose in 24 hour period Cetirizine Hydrochloride 10mg tablets (Cetirizine, Zirtek, Benadryl) Chlorphenamine 4mg tablets (Piriton) Dioralyte Allergy such as hayfever. Mild allergic reaction Mild allergic reaction Diarrhoea & vomiting for 48 hours if dehydrated 10 mg daily 10mg (one tablet) 4mg every 4-6 hours After each loose motion 24mg (six tablets) Contra-indications & special precautions Drowsiness rare, but can occur. Prostatic hypertrophy, urinary retention, glaucoma, pyloro-duodenal obstruction, liver disease. May cause drowsiness & blurred vision can seriously affect ability to drive or operate machinery. Can be given following Cetirizine, if patient not responding to Cetirizine during allergic reaction More than 48 hour history Recent overseas travel Diabetes Kidney and liver impairment Max. duration of treatment before seeking medical opinion

10 Hyoscine hydrobromide 300mcg (Kwells, Joyrides) Loperamide 2mg tablets Paracetamol 500mg Prevention of Motion sickness Treatment of diarrhoea for travel or work requirements Mild to moderate pain Relief of viral illness symptoms Common cold Superficial wounds Eye bath 300mcg thirty mins. before journey, then 6 hrly if req. 2 tablets initially, then 1 after every loose stool 1g every 4-6 hours 900 mcg Can cause drowsiness Glaucoma Cardiovascular disease Kidney impairment Cannot be given at the same time as Cetirizine or Chlorphenamine 16mg (eight tablets) 4g (eight tabs) Keep hydrated Known liver disease Ensure patient is not taking any other Paracetamol-containing product Liver or kidney impairment Alcohol dependence N/A 5 days 0.9% Saline pods Topically 1 day All medicines listed above can be given concurrently unless otherwise stated. I have read and understood the above protocol and agree to abide by its terms. Signed. Print name.. signature. Date

11 CONTROL AND ADMINISTRATION OF MEDICINES AT WINCHESTER COLLEGE Winchester College Staff may give the medicines listed in the Control and Administration of Medicines at Winchester College policy in accordance with the standards agreed... Dr. M. Vincent School Doctor Dr. R. Harlow School Doctor... Mrs K Cullen Lead. Mrs P. McPhee School... Mrs J. Deacock School. Mrs C. Schapira School Mrs S Jennings Mrs L. Selwood School School... Mrs Jo Good School... Mrs A Bailey School... Date.. I have read and understood the Control and Administration of Medicines at Winchester College policy and agree to abide by its terms Signed. Print name..

12 Position Date.. I have read and understood the Control and Administration of Medicines at Winchester College policy and agree to abide by its terms Signed. Print name.. Position Date.. I have read and understood the Control and Administration of Medicines at Winchester College policy and agree to abide by its terms Signed. Print name.. Position Date..